Foot Pain Diagnosis With PET and MR Imaging Combination

Foot pain can be an indicator of various conditions ranging from trauma to serious diseases. Orthopaedics would usually require some tests performed to determine what could be causing the discomfort. A miner rests his feet as he takes a break at a coal mine on the outskirts of Baokang, in central China's Hubei province, June 4, 2007.
REUTERS/STRINGER

Foot pain can be an indicator of various conditions ranging from trauma to serious diseases. Orthopaedics would usually require some tests performed to determine what could be causing the discomfort. A new study introduces an improved option to diagnose chronic foot pain – imaging using 18F-fluoride positron emission tomography and magnetic resonance imaging (PET/MR). This combination can provide more diagnostic information on foot pathologies than other currently used diagnostic tools.

Currently, there are different modalities other than plain radiography used to diagnose certain types of pain in the foot such as bone scanning, PET, MRI, and computed topography (CT). In this study, the combination of PET/MR, can effectively identify different possible causes of foot pain. The research team from the Society of Nuclear Medicine and Molecular Imaging (SNMMI) tested and compared the diagnostic performance of the PET/CT and the PET/MR on 22 patients with undiagnosed foot pain. Overall image by PET/MR was of higher quality compared with the overall image quality using PET/CT.

The results of this study, published in the Journal of Nuclear Medicine, demonstrates the advantage of using PET/MR in the diagnosis of foot pain of unknown causes. Isabel Rauscher, corresponding author of the research, said that the use of 18F-flouride PET/MR furnished more information on bone metabolism and added important findings such as bone marrow pathology as compared with the use of PET/CT. Another advantage is that there is less radiation exposure in using magnetic resonance imaging (MRI).

To determine the exact cause of pain in the foot, accurate diagnosis should be conducted by the proper specialists for proper treatment decisions. Several conditions may be common and associated with orthopaedic problems in the foot, legs, or any part of the lower extremities. However, there are also serious disorders and diseases that cause foot pain and may even affect foot health such as rheumatoid arthritis, gout, and diabetes.

Plain radiography is usually done during preliminary examination of a chronic foot pain. However, when initial results are inadequate, physicians recommend other diagnostic tools such as MRI, which has high quality soft-tissue contrast resolution and multi-planar proficiency. Computed tomography, ultra-sonography, and bone scanning are also useful modalities for analysing particular conditions that cause lingering foot pain.